When a person isn’t able to eat or drink enough by mouth, a feeding tube can help them get the nutrients they need. Tube feeding, also called enteral nutrition, delivers a fortified liquid formula directly into the stomach or small intestine to provide essentials like protein, carbohydrates, fats, vitamins, minerals, and water. Whether it’s used as a food replacement or supplement, tube feeding can help a person stay nourished during and after health challenges.
With the right information and support, tube feeding at home is manageable and effective. You can learn to care for a loved one—whether a senior or a child—who is living at home with a feeding tube and support their well-being.
What Is Tube Feeding, and How Do Feeding Tubes Work?
Feeding tubes are medical devices used to feed people who can't eat or drink. They can also be used to deliver medication. Instead of eating or drinking using the mouth and esophagus, a person uses a tube that’s placed either in their nose or abdomen.
Nose feeding is a non-surgical option where the tube is routed up the nasal canal and then down the esophagus and empties into the stomach. The alternative is an abdominal tube that’s inserted directly into the stomach through an incision site. Both methods allow for the quick passage of food or medication to the stomach and then to the small intestines, where the body can absorb it.
This can be temporary or a more permanent option, depending on the reason for the tube. Regardless, feeding tubes all achieve the same goal: providing nutrition by accessing the digestive system without the need to swallow.
Who Typically Needs Feeding Tubes?
When a person can't eat or drink enough to get the nutrition they need, they may need a feeding tube. This type of care isn't just for someone in the hospital. Many people can benefit from a feeding tube when they're receiving home health care.
Situations where tube feeding at home may be necessary include:
- During Recovery: While recovering from head or neck injuries, a stroke, cancer, eating disorders, or a surgery or illness that has affected the ability to swallow, a person can get the nutrients they require through feeding tube care.
- Digestive Conditions: Certain conditions, like Crohn's and celiac disease, affect the digestive system’s ability to absorb nutrients, making tube feeding necessary.
- Dementia and Psychiatric Illness: In some cases, people with dementia or a psychiatric illness don’t have the interest or ability to eat and require tube feeding.
- Early Childhood Complications: A child might need a feeding tube if they are born with problems in their mouth, esophagus, stomach, or intestines; if they can't seem to gain weight and grow without supplemental nutrition; or if they have problems taking medicine.
Types of Feeding Tubes
Feeding tubes are thin, flexible tubes often differentiated by the site where they're placed—typically either the mouth, nose, or abdomen. However, types of feeding tubes can also be characterized by the length of time for which they’re needed.
Short-Term Feeding Tubes
Feeding tubes needed for short-term care can be inserted by trained medical professionals, such as a licensed home care nurse. These are most commonly nasogastric or orogastric tubes.
Nasogastric (NG) tubes are placed through the nose into the throat and down the esophagus to the stomach. Orogastric (OG) tubes are inserted in the mouth instead of the nose. These feeding tubes are temporary and are often used at home for four to six weeks before they need to be replaced or removed.
"NG tubes are usually easier to insert and use and can be more comfortable for the person compared to an OG tube," explains Susan Ehrlich, RN, BSN, CPD, Regional Director of Clinical Operations at BrightStar Care.
Long-Term Feeding Tubes
When feeding tubes are needed for a longer time, healthcare professionals may use a gastrostomy tube (G-tube), which is surgically inserted into the stomach through the abdomen.
Another option is a jejunostomy tube (J-tube), which also goes through the abdomen but into the small intestine, specifically the jejunum. A gastrojejunal tube (GJ-tube) passes into both the stomach and small intestine. The part of the tube in the stomach is often used to drain air or fluids while the intestinal portion is used for feeding.
If a child needs long-term feeding support, they may have a G-tube placed using a minimally invasive surgical method called percutaneous endoscopic gastrostomy (PEG). This involves inserting an endoscope—a thin, flexible tube with a tiny camera—through the mouth to guide placement of the tube in the stomach, requiring only a small incision.
Understanding PEG tube care is important to keep the feeding tube working as it should. PEG tube care at home can be managed by the patient (if able), their family, and the care team, including in-home pediatric caregivers.
How to Use a Feeding Tube at Home
Using a feeding tube at home allows your loved one to stay in a familiar environment and feel comfortable while providing the nutrition they need. These are the general steps for using a feeding tube at home, but note that the specific care and instructions differ depending on the type of tube:
Prepare the Home Tube Feed
Wash your hands and gather all the needed supplies, including formula, pump, tubing, and syringes. Mix the formula, and pour it into the bag or syringe. Some tube feeds are given by a pump or by gravity and need to be adjusted for how fast or slow the formula goes in. Others use a syringe for feeding all at once (like eating a meal), known as a bolus.
Administer the Feed at Home
Have the patient sit at a 45-degree angle during the feed (and for a few hours after). Flush the tube with warm water to make sure there are no clogs. Pinch the tube and attach the extender or feeding syringe. Unclamp and give the feeding as directed by the patient's healthcare provider. When completed, flush the tube with another 30 mL of warm water and close it.
Seek Help When Needed
A skilled in-home nurse can assist with and provide support and education for caregivers using tube feeding. This includes maintaining the feeding tube, administering feedings, and looking for signs of infection at the site.
Feeding Tube Home Care Guidelines
- Flushing: It's recommended that you flush the tube with at least 30 mL of warm water every four hours, after stopping a feeding for any reason, and before and after giving medications, or as directed by the healthcare provider.
- Cleaning: Clean the area around the tube one to three times a day using a gentle soap and water or sterile saline and a cotton swab. Dry the site well with a towel or gauze.
- Reducing Blockage: When administering medications, it's important to prevent a feeding tube from becoming blocked by ensuring the medications you give in the tube are compatible with the formula. While some medications can be crushed and given through a tube, others should not because it may alter their effectiveness, absorption, or safety. It’s best to consult your healthcare provider or pharmacist anytime you have questions about medications and tube feeding compatibility.
Feeding Tube Supply Management and Organization
There are a lot of supplies that come with home tube feedings, including formula, syringes, extension sets, dressings, and cleaning supplies. Staying organized can help caregivers be successful in managing tube feedings at home. Here are some helpful ideas:
- Create a designated feeding tube station in your home, such as a particular spot in the kitchen. Keep all your supplies there.
- Make a checklist of all feeding tube supplies so you know what should be there and what's running low.
- Periodically check expiration dates on both the formula and supplies. Don't use them if they're past the expiration date.
Tube Feeding on the Go
With some time and planning, caregivers can maintain a normal lifestyle for their loved one, including taking part in activities. Here are some tips:
- When packing feeding tube supplies for an outing, have a checklist and a designated bag or backpack that contains all the needed supplies.
- Pack extra formula and supplies, including pump chargers.
- When flying on an airplane, keep your supplies with you and let security know about your feeding tube.
- Even with a feeding tube, your loved one can be active. However, contact sports may not be advised because of the risk of dislodging the G-tube or J-tube.
Troubleshooting Minor Issues with Tube Feeding
If the feeding tube becomes blocked, don't panic. Try to gently clear the clog with a 30 mL or 60 mL syringe.
- Attach the syringe to the tube and gently pull back on the plunger to try to dislodge the clog.
- Fill the syringe with warm water and flush the tube. Try a gentle back-and-forth motion. Don't use excessive force or sharp objects to try to clear the tube.
- If you can't clear the obstruction, it may need to be replaced.
If feeding supplies like syringes and gravity bags are reusable, wash them in warm, soapy water and then rinse thoroughly and air-dry after each use. The parts should be completely dry before storing to avoid bacterial growth. Make sure you understand how often feeding sets, tubing extensions, and syringes can be cleaned and reused before they need to be tossed.
If you notice signs of infection—such as redness, swelling, warmth, and discharge at the insertion site—or if a tube comes out, notify your healthcare provider right away.
Thriving with a Feeding Tube
Knowing how to take care of a G-tube or J-tube and all the accompanying supplies and information can feel overwhelming. But living at home with a feeding tube can be beneficial for both patients and caregivers.
By bringing in professional assistance, you can feel confident you have the resources and support you need to care for your loved one's health and well-being. Home care service teams can give patients and caregivers professional support and provide ongoing learning so people can live comfortably at home with a feeding tube.
BrightStar Care® Can Support Your Loved One's Nutrition Needs
BrightStar Care® caregivers can help with tube feeding at home, whether you need skilled care or support and education. Whether you're looking for in-home care services for your loved one or a reliable medical staffing partner for your organization, our experienced local care team members are ready to help. Find a location near you, contact us online, or call (866) 618-7827 to learn more about how BrightStar Care offers A Higher Standard®.